Cervical cancer remains one of the leading causes of cancer mortality in women in developing nations. When stratified by race in United States, African American and Hispanic women have both higher incidence and mortality from cervical cancer than Caucasian women. These disparities are in part due to access to healthcare and screening, but even after accounting for this, African American and Hispanic women continue to have higher mortality rates. This grant application describes potential biomarkers that may help begin to understand the differences in progression of the preneoplastic stages of cervical cancer between African American, Hispanic, Caucasian women. The identification of such biomarkers will help determine the biological basis for the observed disparities in the incidences as well as mortality of cervical cancer. In addition, these biomarkers will be useful to identify, among the many women who present with Pap test abnormalities, the few that are at high risk of developing cancer. This will allow for considerable reduction in morbidity as well as cost savings in Pap test follow-up procedures, at the same time providing better, more aggressive care to those who truly need it. PUBLIC HEALTH RELEVANCE: The incidence of cervical cancer is 50% higher in African American women and 66% higher in Hispanic women with mortality rates two-fold higher than what is found in Caucasian women. The disparities among races in part can be attributed to differences in screening and access to healthcare, but after controlling for these factors these disparities persist suggesting that there may be individual susceptibilities to HPV infections. The overall goal of our research is to identify biomarkers that can help predict which women are at highest risk for developing cervical cancer, thus reducing the health disparities that exist for cervical cancer.